Essay 2-Draft 3

Ashley Treatment

Why should parents have the right to make a completely life altering decision for their child? The topic of growth attenuation is being argued ethically between parents and doctors. Growth attenuation is a new procedure used to stop the growth of a child. It has only been used once and the parents of this child are being confronted with many ethical questions. The parents and doctors have many reasons to support the decision they made for their daughter, but the negative outcomes outweigh the positive reasons they provide. People argue that this procedure is best for the child, but they have no idea how it will affect the child later in life.

Growth attenuation is a new procedure used on disabled children. In this procedure, the growth of a child is stopped. The child would then be that size for the rest of his or her life. Also, a hysterectomy is performed on a girl along with the removal of her breast buds. This procedure has only been used once so far. It was used on a severely disabled and mentally impaired young girl named Ashley. Matthew Liao, Julian Savulescu, and Mark Sheehan note in their article that Ashley is a nine year old from Seattle, Washington. She was born with a condition called static encephalopathy. This condition is a sever brain impairment that leaves Ashley unable to walk, talk, eat, sit up, or roll over (Liao, Savulescu, & Sheehan 16). Ashley’s parents are faced with a whirl wind of ethical questions about the procedure they used on their girl.

A big controversy about this procedure was the performance of a hysterectomy and removal of breast buds. According to an article by Sarah Shannon and Terasa Savage, Shannon says there are reasons why these procedures were necessary. One reason for the hysterectomy is because the body is exposed to high estrogen levels which speed up the puberty process. Another reason for the hysterectomy is that it will stop menstruation which can cause skin breakdown and discomfort later in life. The last reason for the hysterectomy is it will abolish the need for pap smears as the girl grows. The breast buds were removed at the same time as the hysterectomy. This was done, because Ashley’s family has a history of large breasts, and large breasts could be potentially painful later in life. Savage argues against Shannon’s assumptions by saying that the risks of a hysterectomy outweigh the potential for cramps and other non threatening conditions. No one knows if she will have pain with her cramps, but if she did they could be treated with hormones like other women are. If all the pain and problems cannot be controlled then later in life a hysterectomy could be performed. Until one knows what the situation is like nothing should be done. Removing the breast because large breasts run in the family is not a good reason. The size of her breasts cannot be pre-determined. She could have had small to normal size breasts which would not be painful (Shannon & Savage 2). The performance of a hysterectomy and removing the breast buds on such a small girl is an ethical debate. Something could have gone wrong during these procedures that could have had a serious impact on Ashley, but along with these procedures the parents of Ashley also face many ethical issues on whether or not stopping the growth of Ashley was the right thing to do or not. The parents of Ashley have reasons why they choose to stop their daughter’s growth.

Ashley’s parents say the reason that they used growth attenuation on their precious daughter was, because it will make caring for her easier in the years to come. According to the article by Bersani, et al., the parents of Ashley used growth attenuation to “minimize the likelihood of a future out-of-home placement by maximizing the future comfort of this child and ensuring a manageable care-giving burden for parents who wanted very much to maintain their daughter in their loving environment (Bersani et al. 351).” Ashley’s parents argue that they will be able to provide Ashley with the best care if she remains small and fragile. They say that they will be able to reposition her more often to prevent bed sores and other infections that come from being bed ridden. It is true that infections do arise from being bed ridden, but as good parents there should be nothing stopping them from giving her the best care she needs. It may require a little more effort, but Ashley’s parents said they would do anything for their daughter (Shannon & Savage 2). Doing some things such as transporting her will be easier, because she will be light and easy to lift. Although with the right training, it is easy to move people of any size. There are many things that were not taken into consideration about Ashley’s life when she is older.

Ashley will have many struggles in life that could have possibly been easier if she was able to grow and develop properly. When Ashley becomes older, she is going to be hard to handle, because she will be frail. It will become hard to lift her without hurting her small frail body. Other things such as having her sit up, bathe, or even eat at a table will be harder with Ashley being so small. If could have been easier for Ashley to do some little things such as just sit up if she could have developed normally. Her developed bones and muscles could have helped her be able to sit up and do other things with little assistance. Ashley will also have to deal with the emotional hardships that come with being a child sized adult. She will never be treated her own age. This could be very hard to deal with emotionally.

Growth attenuation is suppose to make it possible for disabled children to live at home with their families instead of in a group home with adult strangers. Growth attenuation has been used on a girl named Ashley, whose parents claim that because of this procedure they will be able to keep their daughter at home with them. They say that she will be easier to care for since she is so small. Critics of this procedure say that it is unethical to make this kind of life-altering decision for a child. The risks of this procedure are still unknown, and it is not right to stop the growth of a child without even knowing if there could be negative health outcomes later in life. One can only hope that parents of disabled children seriously think about all of the negative possibilities that their child could face before they decide to go through with such a dramatic life altering procedure.


Works Cited
Shannon, Savage, and Teresa Savage. “The Ashley Treatment: Two Viewpoints.” Pediatric Nursing 33.2 (2007) 175-8. Academic Search Premier. EBSCO. University of South Dakota, ID Weeks Lib., SD. 13 February 2008 .

Liao, S. Matthew, Julian Savulescu, and Mark Sheehan. “The Ashley Treatment: Best Interests, Convenience, and Parental Decision-Making.” Hastings Center Report 37.2 (2007): 16-20. Academic Search Premier. EBSCO. University of South Dakota, ID Weeks Lib., SD. 13 February 2008 .

Bersani, Hank, et al. “Unjustifiable Non-Therapy: Response to the Issue of Growth Attenuation for Young People on the basis of Disability.” American Association on Intellectual and developmental Disabilities 45.5 (2007): 351-353. Academic Search Premier. EBSCO. University of South Dakota, ID Weeks Lib., SD. 13 February 2008 .